Study: Primary Care Career Wealth Gap Totals Over $2.5 Million

Specialists like cardiologists earn twice as much, on average, as primary care physicians over the course of a career, but both types of doctors make significantly more than business school or college graduates, according to a new analysis published in Health Affairs.

To better understand the financial payoff for specialists, researchers at Duke University modeled the earning potential of cardiologists and primary care physicians between the ages of 22 and 65, taking into account medical school debt, earning potential and the age at which doctors begin earning an income. They conducted similar analyses for the average b-school, physician assistant and college graduate.

Their calculations showed that cardiologists earn a career average of more than $5 million, compared with $2.5 million for primary care physicians, $1.7 million for business school graduates, $846,735 for physician assistants and $340,629 for college graduates, according to the paper.

“This reality check is interesting,” says Kevin Schulman, a professor of medicine and business administration at Duke University, and one of the study’s authors. “Although primary care physicians relative to other physicians aren’t well off … relative to others [in different professions] they are.”

The researchers also calculated by how much compensation would need to be adjusted to make primary care more financially attractive to medical students. To make up for the difference in income over the course of a career, primary care doctors would have to receive a $1 million lump-sum payment or have an annual income boost of $100,000, according to the analysis.

“Small incentives are not going to be enough to shift the market in a dynamic way,” says Schulman. “The magnitude of the differential on the income side is greater than anything we’ve been talking about on the policy level.”

Potential changes to shift the system could include cutting reimbursement to specialists or raising primary care doctors’ salaries to some percentage of what’s earned by specialists, but there are drawbacks to both strategies, according to Schulman. Another strategy is to increase the efficiency of the primary care system by employing more nurse practitioners or physician assistants, he says.

“It’s really a question of how do we deliver primary care and who should do it,” said Schulman.

Comments (5 of 18)

Third-party free physician trained In primary care, but left the ship for concierge care.

Working no more than 30 hours a week, no call, insurance or irrational slavery with better paid than the 24/7 do-it-all PCP slave.

Yes, something is wrong when a PA makes 120K working in the ER, while PCP's get hounded by the insurance companies over pennies. However, the pendulum is SLLLLLOWLY shifting. Concierge physicians in high-end communities that find their niche and get rid of insurances can do VERY well and this demand is rising.

Get out of the medical slavery and it will all be good. Finally, for those who think primary care docs are not good enough, get an appointment to the oncologist next time you want cancer screening or simply have any vague issue. Patients nowadays are thankless and expectant to the hilt and will squeal if they have to pay a copay of the prize of a big mac.

9:20 am April 14, 2013

Medical relationship site wrote :

Wow relay nice weblog. Will likely be show this of my person on my Health care dating web-site. Hope these people find more from your weblog.

9:32 am August 26, 2010

Inquirer wrote :

A question for the physicians reading this post: Do you see any possibility for an alternative training route for those wishing to become primary care physicians? In other words, since it doesn't seem easy to compensate for the income difference between primary care physicians and specialists, might it be possible one day for people to pursue a career in primary care medicine that wouldn't involve the exorbitant costs of medical-school-as-we-know-it?

3:12 pm May 20, 2010

Patient wrote :

I think of my primary care physician as a diagnostic specialist...

1:22 pm May 9, 2010

Primary care doc wrote :

Here's where the dollars go that should go to primary care physicians:
Total compensation packages from 2008 based on information gathered from the U.S. Security and Exchange Commission.